Psychotropic Polypharmacy in Dementia: A Retrospective Analysis for People with Neuropsychiatric Symptoms Referred to an Australian Dementia Support Service.

Background And Objectives: Despite their limited benefits and serious adverse effects, psychotropics remain frequently prescribed for neuropsychiatric symptoms (NPS) of dementia. Psychotropic polypharmacy, the use of two or more concomitant psychotropic medications, is therefore not recommended for people with dementia. The objectives of this study were to investigate the prevalence of psychotropic polypharmacy in Australians living with dementia whose caregivers sought external NPS support from Dementia Support Australia (DSA; the national provider of NPS support) and the association of psychotropic polypharmacy with their demographics and NPS characteristics.

Pembrolizumab and chemotherapy in high-risk, early-stage, ER/HER2 breast cancer: a randomized phase 3 trial.

Addition of pembrolizumab to neoadjuvant chemotherapy followed by adjuvant pembrolizumab improved outcomes in patients with high-risk, early-stage, triple-negative breast cancer. However, whether the addition of neoadjuvant pembrolizumab to chemotherapy would improve outcomes in high-risk, early-stage, estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER/HER2) breast cancer remains unclear. We conducted a double-blind, placebo-controlled phase 3 study (KEYNOTE-756) in which patients with previously untreated ER/HER2 grade 3 high-risk invasive breast cancer (T1c-2 (≥2 cm), cN1-2 or T3-4, cN0-2) were randomly assigned (1:1) to neoadjuvant pembrolizumab 200 mg or placebo Q3W given with paclitaxel QW for 12 weeks, followed by four cycles of doxorubicin or epirubicin plus cyclophosphamide Q2W or Q3W.

Insights from a century of data reveal global trends in ex situ living plant collections.

Ex situ living plant collections play a crucial role in providing nature-based solutions to twenty-first century global challenges. However, the complex dynamics of these artificial ecosystems are poorly quantified and understood, affecting biodiversity storage, conservation and utilization. To evaluate the management of ex situ plant diversity, we analysed a century of data comprising 2.

Molten Sn solvent expands liquid metal catalysis.

Regulating favorable assemblies of metallic atoms in the liquid state provides promise for catalyzing various chemical reactions. Expanding the selection of metallic solvents, especially those with unique properties and low cost, enables access to distinctive fluidic atomic structures on the surface of liquid alloys and offers economic feasibility. Here, Sn solvent, as a low-cost commodity, supports unique atomic assemblies at the interface of molten SnInCu, which are highly selective for H synthesis from hydrocarbons.

Developing multifactorial dementia prediction models using clinical variables from cohorts in the US and Australia.

Existing dementia prediction models using non-neuroimaging clinical measures have been limited in their ability to identify disease. This study used machine learning to re-examine the diagnostic potential of clinical measures for dementia. Data was sourced from the Australian Imaging, Biomarkers, and Lifestyle Flagship Study of Ageing (AIBL) and the Alzheimer's Disease Neuroimaging Initiative (ADNI).

Erratum: Meningococcal Surveillance Australia: Reporting period 1 April to 30 June 2024.

Erratum to 2024;48. (doi: 10.33321/cdi.

Tibial Plateau Angle Changes following Repair of Salter-Harris Type 1 and 2 Fractures in Dogs.

Objective:  To determine (1) whether the tibial plateau angle (TPA) in dogs with Salter-Harris type 1 (SH-1) or type 2 (SH-2) fractures of the proximal tibial physis significantly decreases in the time between diagnosis and reevaluation following surgical repair and (2) whether the method of surgical repair influences the change in TPA over time.

Study Design:  This study was a retrospective study. Medical records from 2017 to 2022 were reviewed to identify dogs with SH-1 or SH-2 fractures of the proximal tibial physis that had undergone surgical repair with Kirschner wires (K-wires), with or without a tibial tuberosity tension band.

Factors that influence the decision to release rehabilitated koalas (Phascolarctos cinereus) to fire-affected home sites.

This study appraises recent research to critically evaluate knowledge on the factors that influence decisions around the release of rehabilitated koalas to fire-affected home sites. Availability of koala release sites could be compromised at times in the future by the increasing incidence of large and intense bushfires due to climate change. In addition, factors such as the fragmentation of koala habitat and increasing urbanisation impose other threats to the long-term survival of the released koala.

Sociocultural and perinatal health factors associated with Autism spectrum disorder (ASD) in children.

While previous research has examined perinatal factors in the context of Autism Spectrum Disorder (ASD), studies focusing on sociocultural factors is limited. We conducted a cross-sectional analysis utilizing data from the Australian Autism Biobank (AAB), which encompasses autistic children aged 2-17, their siblings, parents, and unrelated controls. Employing multivariable regression analyses, we aimed to identify factors associated with ASD across various domains, spanning health and lifestyle, perinatal, and postnatal contexts.

The moderating effect of diet on the relationship between depressive symptoms and Alzheimer's disease-related blood-based biomarkers.

Associations between mental health, diet, and risk of Alzheimer's disease highlight the need to investigate whether dietary patterns moderate the relationship between symptoms of depression and anxiety, and neurodegeneration-related blood-based biomarkers. Cognitively unimpaired participants (n = 89) were included from the Australian Imaging, Biomarkers and Lifestyle study (mean age 75.37; 44 % male).

Clinician views on selective decontamination of the digestive tract in mechanically ventilated patients in intensive care units: A survey.

Objective: Selective decontamination of the digestive tract (SDD) has been investigated as a strategy to reduce the incidence of ventilator-associated pneumonia (VAP) and other healthcare-associated infections in intensive care unit (ICU) patients receiving mechanical ventilation. There is some evidence to suggest that the use of SDD is associated with a reduction in healthcare-associated infection and mortality; however, the uptake of SDD in ICUs in Australia and New Zealand (ANZ) remains low. To better understand the potential reasons, we designed a questionnaire to gather views from specialists in intensive care medicine, infectious diseases, and medical microbiology.

Detection of hypertension and blood pressure phenotypes using ambulatory blood pressure monitoring in women with past hypertensive disorders of pregnancies.

Objective: To evaluate the incidence of hypertension and blood pressure (BP) phenotypes using 24-hour ambulatory BP (24hr-ABP) in women with past pregnancy complications who were recruited into a Women's Heart Clinic (WHC).

Study Design: We recruited 156 women aged 30-55 years with past hypertensive disorders of pregnancy (HDP) and/or gestational diabetes (GDM) to a multidisciplinary six-month WHC that provided cardiovascular risk management in Melbourne, Australia. Women were referred for 24 hr-ABP monitoring if clinic BP was ≥130/80 mmHg.

Mortality among 5 to 19-year-olds in rural Mali.

The unique healthcare needs of 5 to 9-year-olds and adolescents (10-19 years) in low- and middle-income countries have been largely neglected. We generated estimates of 5 to 9-year-old and adolescent mortality in rural Mali, a setting with high under-five mortality, and aimed to define associated individual and household risk factors. We analysed cross-sectional baseline household survey data from the ProCCM trial (NCT02694055) conducted in Bankass District, Mali collected in December 2016 and January 2017.

Single-cell and spatial transcriptomics illuminate bat immunity and barrier tissue evolution.

Bats have adapted to pathogens through diverse mechanisms, including increased resistance - rapid pathogen elimination, and tolerance - limiting tissue damage following infection. In the Egyptian fruit bat (an important model in comparative immunology) several mechanisms conferring disease tolerance were discovered, but mechanisms underpinning resistance remain poorly understood. Previous studies on other species suggested that elevated basal expression of innate immune genes may lead to increased resistance to infection.

Adenocarpine, Marmesin, and Lycocernuine from Ficus benjamina as Promising Inhibitors of Aldose Reductase in Diabetes: A Bioinformatics-Guided Approach.

Diabetes affects approximately 422 million people worldwide, leading to 1.5 million deaths annually and causing severe complications such as kidney failure, neuropathy, and cardiovascular disease. Aldose reductase (AR), a key enzyme in the polyol pathway, is an important therapeutic target for managing these complications.

Novel technique and outcomes of umbilical reconstruction during cytoreductive surgery; a multi-centre study.

Background: The goal of cytoreductive surgery for peritoneal malignancy is to remove all macroscopic disease, which occasionally requires the excision of the umbilicus. While the absence of the umbilicus can be aesthetically undesirable for patients, umbilical reconstruction is rarely performed due to the perceived complexity and increased risk of wound infections (Sakata et al. in Colorectal Dis 23:1153-1157, 2021).

Composite Primary Outcomes Reported in Studies of Critical Care: A Scoping Review.

Objective: Composite primary outcomes (CPO) (incorporating both mortality and non-mortality outcomes) offer several advantages over mortality as an outcome for critical care research. Our objective was to explore and map the literature to report on CPO evaluated in critical care research.

Data Sources: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Cochrane Library from January 2000 to January 2024.

Digestion of food proteins: the role of pepsin.

The nutritive value of a protein is determined not only by its amino acid composition, but also by its digestibility in the gastrointestinal tract. The interaction between proteins and pepsin in the gastric stage is the first step and plays an important role in protein hydrolysis. Moreover, it affects the amino acid release rates and the allergenicity of the proteins.

Improved Annotation of Asthma Gene Variants with Cell Type Deconvolution of Nasal and Lung Expression-Quantitative Trait Loci.

Asthma is a genetically complex inflammatory airway disease associated with over 200 Single nucleotide polymorphisms (SNPs). However, the functional effects of many asthma-associated SNPs in lung and airway epithelial samples are unknown. Here, we aimed to conduct expression quantitative trait loci (eQTL) analysis using a meta-analysis of nasal and lung samples.

Visual Stimulus Materials Used in Spoken Narrative Discourse Elicitation After Traumatic Brain Injury: A Scoping Review.

Purpose: Management of discourse is acknowledged as a critical component of speech-language pathology practice with cognitive communication after traumatic brain injury (TBI). This scoping review aimed to collate the visual materials that are being used in empirical research for spoken narrative elicitation post-TBI, in both assessment and treatment contexts. We aimed to examine the format, structure, and sources for visuals used.

The Blood-Cerebrospinal Fluid Barrier as a Potential Entry Site for the SARS-CoV-2 Virus.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an RNA virus responsible for coronavirus disease 2019 (COVID-19). While SARS-CoV-2 primarily targets the lungs and airways, it can also infect other organs, including the central nervous system (CNS). The aim of this study was to investigate whether the choroid plexus could serve as a potential entry site for SARS-CoV-2 into the brain.

Psychological Assessment and Motivations of Potential Donors Within the First Australian Uterine Transplant Trial.

Objective: This study aims to investigate the psychological characteristics, motivations and experiences of potential living donors assessed for the first uterus transplant (UTx) clinical trial in Australia.

Design: Mixed methods study.

Setting: Tertiary hospital.

Developing a co-designed, culturally responsive physical activity program for Pasifika communities in Western Sydney, Australia.

Pasifika communities in Western Sydney experience significant health disparities, particularly related to chronic diseases such as cardiovascular conditions and diabetes. Physical activity is known to improve both physical and mental health, yet access to culturally responsive physical activity programs for Pasifika communities is limited. This study leveraged expertise from an Advisory Committee to adopt community-based participatory research (CBPR) through Talanoa to co-design a physical activity program specifically tailored for Pasifika people in Western Sydney.

Anticoagulant Overdose With Paradoxical Thrombotic Risk.

We report a case of an unusual polypharmacy overdose including warfarin in a patient with a metallic heart valve, complicated by the history that he had ceased taking anticoagulation in the preceding few months, that placed him in an initial prothrombotic phase during his presentation. Our case highlights the importance of elucidating all relevant clinical details in a polypharmacy overdose, as clearly and rapidly as feasible, to enable appropriate management.